par Mouawad, Émile 
;Van Laere, Éliane ;Smets, Philippe
Référence Acta Anaesthesiologica Belgica, 26, 1, page (61-71)
Publication Publié, 1975
;Van Laere, Éliane ;Smets, Philippe Référence Acta Anaesthesiologica Belgica, 26, 1, page (61-71)
Publication Publié, 1975
Article révisé par les pairs
| Résumé : | In case of cranial trauma, early respiratory troubles either of central or peripheral origin, often accelerate the deterioration of the neurologic situation. The different values of PCO2, PO2, pH and alkaline reserve measured on samples of CSF in comatose patients prove the central acidosis related to metabolic and vascular disorders in the damaged areas. The results confirm the correlation between the importance of these disturbances and the severity of the trauma. It is thus necessary to insure patients of satisfactory respiratory conditions. The tracheobronchial cleansing is applicable to intubated or tracheotomized patients by an instillation of 5 ml of simple or bicarbonated physiologic serum 4 to 6 times a day, followed by repeated aspirations and associated with a preventive endotracheal instillation of 80 mg of Gentamycin 4 times a day. Moreover, the authors use controlled respiration which does not modify the gazometric parameters in the CSF but which assures patients a normoxia and moderate hypocapnia with a decrease of intracranial hypertension. Treatment by controlled hyperventilation must be early, because the recuperation at the level of the damaged zones is very slow. |
